Amygdala and cortical gamma-band responses to emotional faces are modulated by attention to valence.

The amygdala might support an attentional bias for emotional faces. However, whether and how selective attention toward a specific valence modulates this bias is not fully understood. Likewise, it is unclear whether amygdala and cortical signals respond to emotion and attention in a similar way. We recorded gamma-band activity (GBA, > 30 Hz) intracranially in the amygdalae of 11 patients with epilepsy and collected scalp recordings from 19 healthy participants. We presented angry, neutral, and happy faces randomly, and we denoted one valence as the target. Participants detected happy targets most quickly and accurately. In the amygdala, during attention to negative faces, low gamma-band activity (LGBA, < 90 Hz) increased for angry compared with happy faces from 160 ms. From 220 ms onward, amygdala high gamma-band activity (HGBA, > 90 Hz) was higher for angry and neutral faces than for happy ones. Monitoring neutral faces increased amygdala HGBA for emotions compared with neutral faces from 40 ms. Expressions were not differentiated in GBA while monitoring positive faces. On the scalp, only threat monitoring resulted in expression differentiation. Here, posterior LGBA was increased selectively for angry targets from 60 ms. The data show that GBA differentiation of emotional expressions is modulated by attention to valence: Top-down-controlled threat vigilance coordinates widespread GBA in favor of angry faces. Stimulus-driven emotion differentiation in amygdala GBA occurs during a neutral attentional focus. These findings align with a multi-pathway model of emotion processing and specify the role of GBA in this process.

MRI evidence for material-specific encoding deficits and mesial-temporal alterations in presurgical frontal lobe epilepsy patients.

OBJECTIVE: Neuroimaging studies reveal frontal lobe (FL) contributions to memory encoding. Accordingly, memory impairments are documented in frontal lobe epilepsy (FLE). Still, little is known about the structural or functional correlates of such impairments. Particularly, material specificity of functional changes in cerebral activity during memory encoding in FLE is unclear. METHODS: We compared 24 FLE patients (15 right-sided) undergoing presurgical evaluation with 30 healthy controls on a memory fMRI-paradigm of learning scenes, faces, and words followed by an out-of-scanner recognition task as well as regarding their mesial temporal lobe (mTL) volumes. We also addressed effects of FLE lateralization and performance level (normal vs. low). RESULTS: FLE patients had poorer memory performance and larger left hippocampal volumes than controls. Volume increase seemed, however, irrelevant or even dysfunctional for memory performance. Further, functional changes in FLE patients were right-sided for scenes and faces and bilateral for words. In detail, during face encoding, FLE patients had, regardless of their performance level, decreased mTL activation, while during scene and word encoding only low performing FLE patients had decreased mTL along with decreased FL activation. Intact verbal memory performance was associated with higher right frontal activation in FLE patients but not in controls. SIGNIFICANCE: Pharmacoresistant FLE has a distinct functional and structural impact on the mTL. Effects vary with the encoded material and patients' performance levels. Thus, in addition to the direct effect of the FL, memory impairment in FLE is presumably to a large part due to functional mTL changes triggered by disrupted FL networks. PLAIN LANGUAGE SUMMARY: Frontal lobe epilepsy (FLE) patients may suffer from memory impairment. Therefore, we asked patients to perform a memory task while their brain was scanned by MRI in order to investigate possible changes in brain activation during learning. FLE patients showed changes in brain activation during learning and also structural changes in the mesial temporal lobe, which is a brain region especially relevant for learning but not the origin of the seizures in FLE. We conclude that FLE leads to widespread changes that contribute to FLE patients' memory impairment.

The effect of neural pre-stimulus oscillations on post-stimulus somatosensory event-related potentials in disorders of consciousness.

Brain activity of people in a disorder of consciousness (DoC) is diffuse and different from healthy people. In order to get a better understanding of their cognitive processes and functions, electroencephalographic activity has often been examined in patients with DoC, including detection of event-related potentials (ERPs) and spectral power analysis. However, the relationship between pre-stimulus oscillations and post-stimulus ERPs has rarely been explored in DoC, although it is known from healthy participants that pre-stimulus oscillations predispose subsequent stimulus detection. Here, we examine to what extent pre-stimulus electroencephalography band power in DoC relates to post-stimulus ERPs in a similar way as previously documented in healthy people. 14 DoC patients in an unresponsive wakefulness syndrome (UWS, N = 2) or a minimally conscious state (MCS, N = 12) participated in this study. In an active oddball paradigm patients received vibrotactile stimuli. Significant post-stimulus differences between brain responses to deviant and standard stimulation could be found in six MCS patients (42.86%). Regarding relative pre-stimulus frequency bands, delta oscillations predominated in most patients, followed by theta and alpha, although two patients showed a relatively normal power spectrum. The statistical analysis of the relationship between pre-stimulus power and post-stimulus event-related brain response showed multiple significant correlations in five out of the six patients. Individual results sometimes showed similar correlation patterns as in healthy subjects primarily between the relative pre-stimulus alpha power and post-stimulus variables in later time-intervals. However, opposite effects were also found, indicating high inter-individual variability in DoC patients´ functional brain activity. Future studies should determine on an individual level to what extent the relationship between pre- and post-stimulus brain activity could relate to the course of the disorder.

Hemodynamic correlates of emotion regulation in frontal lobe epilepsy patients and healthy participants.

The ability to regulate emotions is indispensable for maintaining psychological health. It heavily relies on frontal lobe functions which are disrupted in frontal lobe epilepsy. Accordingly, emotional dysregulation and use of maladaptive emotion regulation strategies have been reported in frontal lobe epilepsy patients. Therefore, it is of clinical and scientific interest to investigate emotion regulation in frontal lobe epilepsy. We studied neural correlates of upregulating and downregulating emotions toward aversive pictures through reappraisal in 18 frontal lobe epilepsy patients and 17 healthy controls using functional magnetic resonance imaging. Patients tended to report more difficulties with impulse control than controls. On the neural level, patients had diminished activity during upregulation in distributed left-sided regions, including ventrolateral and dorsomedial prefrontal cortex, angular gyrus and anterior temporal gyrus. Patients also showed less activity than controls in the left precuneus for upregulation compared to downregulation. Unlike controls, they displayed no task-related activity changes in the left amygdala, whereas the right amygdala showed task-related modulations in both groups. Upregulation-related activity changes in the left inferior frontal gyrus, insula, orbitofrontal cortex, anterior and posterior cingulate cortex, and precuneus were correlated with questionnaire data on habitual emotion regulation. Our results show that structural or functional impairments in the frontal lobes disrupt neural mechanisms underlying emotion regulation through reappraisal throughout the brain, including posterior regions involved in semantic control. Findings on the amygdala as a major target of emotion regulation are in line with the view that specifically the left amygdala is connected with semantic processing networks.

Different ways to forget: Electrophysiological mechanisms underlying item-method directed forgetting of angry and neutral faces.

Emotional stimuli, including faces, receive preferential processing and are consequently better remembered than neutral stimuli. Therefore, they may also be more resistant to intentional forgetting. The present study investigates the behavioral and electrophysiological consequences of instructions to selectively remember or forget angry and neutral faces. In an item-method directed forgetting experiment, angry and neutral faces were randomly presented to 25 student participants (4 males). Each face was followed by an instruction to either forget or remember it and the participants' EEG was recorded. Later, recognition memory was unexpectedly tested for all items. Behaviorally, both hit and false alarm rates were higher for angry alike than for neutral faces. Directed forgetting occurred for neutral and angry faces as reflected in a reduction of both recognition accuracy and response bias. Event-related potentials revealed a larger late positive potential (LPP, 450 - 700 ms) for angry than for neutral faces during face presentation and, in line with selective rehearsal of remember items, a larger LPP following remember than forget cues. Forget cues generally elicited a larger frontal N2 (280 - 400 ms) than remember cues, in line with the forget instruction eliciting conflict monitoring and inhibition. Selectively following angry faces, a larger cue-evoked P2 (180 - 280 ms) was observed. Notably, forget cues following angry faces elicited a larger late frontal positivity (450 - 700 ms) potentially signaling conflict resolution. Thus, whereas both angry and neutral faces are subject to directed forgetting, on a neural level, different mechanisms underlie the effect. While directed forgetting for neutral faces may be achieved primarily by selective rehearsal, directed forgetting of angry faces involves an additional late frontal positivity, likely reflecting higher cognitive demands imposed by forgetting angry faces.

Face processing and efficient recognition of facial expressions are impaired following right but not left anteromedial temporal lobe resections: Behavioral and fMRI evidence.

Anteromedial temporal lobe structures seem to support processing of faces and facial expressions. However, differential effects of unilateral left or right temporal lobe resections (TLR) on face processing, recognition of facial expressions, and on BOLD response to faces in intact brain areas are not yet fully understood. Therefore, we compared 39 patients with unilateral TLR (18 left, 21 right) and 20 healthy controls regarding recognition of facial identity and emotional facial expressions as well as BOLD response to fearful and neutral faces. We found impaired recognition of facial identity following right TLR, which was paralleled by reduced BOLD response to faces irrespective of expression in the right fusiform and lingual gyrus in postsurgical fMRI. Right TLR patients also exhibited subtle impairments of emotion recognition as they needed higher intensity of facial expressions for correct responses in a morphing task. Accuracy of emotion recognition and subjective appraisals of facial expressions did not differ between groups. There was no specific reduction of BOLD response to fearful versus neutral faces in either patient group. Our results underline the specific role of the right anteromedial temporal lobe in processing of faces and facial expressions by showing changes in face processing following right TLR in behavioral as well as imaging data.

Emotion and attention in face processing: Complementary evidence from surface event-related potentials and intracranial amygdala recordings.

Face processing is biased by emotional and voluntarily directed attention, both of which modulate processing in distributed cortical areas. The amygdala is assumed to contribute to an attentional bias for emotional faces, although its interaction with directed attention awaits further clarification. Here, we studied the interaction of emotion and attention during face processing via scalp EEG potentials of healthy participants and intracranial EEG (iEEG) recordings of the right amygdala in one patient. Three randomized blocks consisting of angry, neutral, and happy facial expressions were presented, and one expression was denoted as the target category in each block. Happy targets were detected fastest and most accurately both in the group study and by the iEEG patient. Occipital scalp potentials revealed emotion differentiation for happy faces in the early posterior negativity (EPN) around 300 ms after stimulus onset regardless of the target condition. A similar response to happy faces occurred in the amygdala only for happy targets. On the scalp, a late positive potential (LPP, around 600 ms) enhancement for targets occurred for all target conditions alike. A simultaneous late signal in the amygdala was largest for emotional targets. No late signal enhancements were found for neutral targets in the amygdala. Cortical modulations, by contrast, showed both attention-independent effects of emotion and emotion-independent effects of attention. These results demonstrate an attention-dependence of amygdala activity during the processing of facial expressions and partly independent cortical mechanisms.

Effects of left and right medial temporal lobe resections on hemodynamic correlates of negative and neutral scene processing.

Enhanced visual cortex activation by negative compared to neutral stimuli is often attributed to modulating feedback from the amygdala, but evidence from lesion studies is scarce, particularly regarding differential effects of left and right amygdala lesions. Therefore, we compared visual cortex activation by negative and neutral complex scenes in an event-related fMRI study between 40 patients with unilateral temporal lobe resection (TLR; 19 left [lTLR], 21 right [rTLR]), including the amygdala, and 20 healthy controls. We found preserved hemodynamic emotion modulation of visual cortex in rTLR patients and only subtle reductions in lTLR patients. In contrast, rTLR patients showed a significant decrease in visual cortex activation irrespective of picture content. In line with this, healthy controls showed small emotional modulation of the left amygdala only, while their right amygdala was activated equally by negative and neutral pictures. Correlations of activation in amygdala and visual cortex were observed for both negative and neutral pictures in the controls. In both patient groups, this relationship was attenuated ipsilateral to the TLR. Our results support the notion of reentrant mechanisms between amygdala and visual cortex and suggest laterality differences in their emotion-specificity. While right medial temporal lobe structures including the amygdala seem to influence visual processing in general, the left medial temporal lobe appears to contribute specifically to emotion processing. Still, effects of left TLR on visual emotion processing were relatively subtle. Therefore, hemodynamic correlates of visual emotion processing are likely supported by a distributed cerebral network, challenging an amygdalocentric view of emotion processing.

Encoding in a social feedback context enhances and biases behavioral and electrophysiological correlates of long-term recognition memory.

Encoding often occurs in social contexts, yet research has hardly addressed their role in verbal memory. In three experiments, we investigated the behavioral and neural effects of encoding context on memory for positive, negative, and neutral adjectives, contrasting a social-feedback group (N = 24) with an explicit verbal-learning (N = 24) and a levels-of-processing group (N = 24). Participants in the social-feedback group were not aware of a recognition session one week later, but their memory was better than the explicit learning or the levels-of-processing groups'. However, they also exhibited the strongest response bias, particularly for positive words. Brain event-related potentials (ERPs) revealed largest early negativities (EPN) and late positivities (LPP) in the social-feedback group. Only in the subsequent slow-wave did the explicit learning group show higher amplitudes than the other two groups, suggesting reliance on strategic rather than automatic processes. Still, context-driven incidental encoding outweighed explicit instructions, specifying a decisive role of social factors in memory.

Right medial temporal lobe structures particularly impact early stages of affective picture processing.

Human vision prioritizes emotional stimuli. This is reflected in stronger electrocortical activation in response to emotional than neutral stimuli, measurable on the surface of the head. Feedback projections from brain structures deep within the medial temporal lobes (mTLs), in particular the amygdala, are thought to give rise to this phenomenon, although causal evidence is rare. Given the many pathways involved in visual processing, the influence of mTL structures could be restricted to specific time windows. Therefore, we delineate the temporal dynamics of the impact of right mTL structures on affective picture processing, investigating event-related potentials (ERPs) in 19 patients (10 female) with right mTL resections and 19 individually matched healthy participants, while they viewed negative and neutral scenes. Groups differed significantly at early- and mid-latency processing stages. Patients with right mTL resection, unlike controls, showed no (P1: 90-140 ms) or marginal (N1: 170-220 ms) emotion modulation. At mid-latency (early posterior negativity: 220-370 ms), emotion modulation over the ipsi-resectional right hemisphere was smaller in patients than in controls, but groups did not differ over the left hemisphere. During late parietal positivities (400-650 ms and 650-900 ms), both groups had similar emotion modulation. Our results demonstrate that right mTL structures attenuate particularly early processing of affectively negative scenes. This is theoretically consistent with an initial amygdala-dependent feedforward sweep in visual emotion processing whose absence is successively compensated. Findings specify the impact of right mTL structures on emotional picture processing and highlight the value of time-resolved measures in affective neuroscience.

Different Patterns of Attention Modulation in Early N140 and Late P300 sERPs Following Ipsilateral vs. Contralateral Stimulation at the Fingers and Cheeks.

Intra-hemispheric interference has been often observed when body parts with neighboring representations within the same hemisphere are stimulated. However, patterns of interference in early and late somatosensory processing stages due to the stimulation of different body parts have not been explored. Here, we explore functional similarities and differences between attention modulation of the somatosensory N140 and P300 elicited at the fingers vs. cheeks. In an active oddball paradigm, 22 participants received vibrotactile intensity deviant stimulation either ipsilateral (within-hemisphere) or contralateral (between-hemisphere) at the fingers or cheeks. The ipsilateral deviant always covered a larger area of skin than the contralateral deviant. Overall, both N140 and P300 amplitudes were higher following stimulation at the cheek and N140 topographies differed between fingers and cheek stimulation. For the N140, results showed higher deviant ERP amplitudes following contralateral than ipsilateral stimulation, regardless of the stimulated body part. N140 peak latency differed between stimulated body parts with shorter latencies for the stimulation at the fingers. Regarding P300 amplitudes, contralateral deviant stimulation at the fingers replicated the N140 pattern, showing higher responses and shorter latencies than ipsilateral stimulation at the fingers. For the stimulation at the cheeks, ipsilateral deviants elicited higher P300 amplitudes and longer latencies than contralateral ones. These findings indicate that at the fingers ipsilateral deviant stimulation leads to intra-hemispheric interference, with significantly smaller ERP amplitudes than in contralateral stimulation, both at early and late processing stages. By contrast, at the cheeks, intra-hemispheric interference is selective for early processing stages. Therefore, the mechanisms of intra-hemispheric processing differ from inter-hemispheric ones and the pattern of intra-hemispheric interference in early and late processing stages is body-part specific.

Whole-brain functional correlates of memory formation in mesial temporal lobe epilepsy.

The mesial temporal lobe is a key region for episodic memory. Accordingly, memory impairment is frequent in patients with mesial temporal lobe epilepsy. However, the functional relevance of potentially epilepsy-induced reorganisation for memory formation is still not entirely clear. Therefore, we investigated whole-brain functional correlates of verbal and non-verbal memory encoding and subsequent memory formation in 56 (25 right sided) mesial temporal lobe epilepsy patients and 21 controls. We applied an fMRI task of learning scenes, faces, and words followed by an out-of-scanner recognition test. During encoding of faces and scenes left and right mesial temporal lobe epilepsy patients had consistently reduced activation in the epileptogenic mesial temporal lobe compared with controls. Activation increases in patients were apparent in extra-temporal regions, partly associated with subsequent memory formation (left frontal regions and basal ganglia), and patients had less deactivation in regions often linked to the default mode and auditory networks. The more specific subsequent memory contrast indicated only marginal group differences. Correlating patients' encoding activation with memory performance both within the paradigm and with independent clinical measures demonstrated predominantly increased contralateral mesio-temporal activation supporting intact memory performance. In left temporal lobe epilepsy patients, left frontal activation was also correlated with better verbal memory performance. Taken together, our findings hint towards minor extra-temporal plasticity in mesial temporal lobe epilepsy patients, which is in line with pre-surgical impairment and post-surgical memory decline in many patients. Further, data underscore the importance of particularly the contralateral mesial temporal lobe itself, to maintain intact memory performance.

Investigating the roles of age, sex, depression, and anxiety for valence and arousal ratings of words: a population-based study.

BACKGROUND: The perception of the affective quality of stimuli with regard to valence and arousal has mostly been studied in laboratory experiments. Population-based research may complement such studies by accessing larger, older, better balanced, and more heterogeneous samples. Several characteristics, among them age, sex, depression, or anxiety, were found to be associated with affective quality perception. Here, we intended to transfer valence and arousal rating methods from experimental to population-based research. Our aim was to assess the feasibility of obtaining and determining the structure of valence and arousal ratings in the setting of the large observational BiDirect Study. Moreover, we explored the roles of age, sex, depression, and anxiety for valence and arousal ratings of words. METHODS: 704 participants provided valence and arousal ratings for 12 written nouns pre-categorized as unpleasant, neutral, or pleasant. Predictors of valence and arousal ratings (i.e. age, sex, depression, and anxiety) were analyzed for six outcomes that emerge by combining two affective dimensions with three words categories. Data were modeled with multiple linear regression. Relative predictor importance was quantified by model-explained variance decomposition. RESULTS: Overall, average population-based ratings replicated those found in laboratory settings. The model did not reach statistical significance in the valence dimension. In the arousal dimension, the model explained 5.4% (unpleasant), 4.6% (neutral), and 3.5% (pleasant) of the variance. (Trend) effects of sex on arousal ratings were found in all word categories (unpleasant: increased arousal in women; neutral, pleasant: decreased arousal in women). Effects of age and anxiety (increased arousal) were restricted to the neutral words. CONCLUSIONS: We report results of valence and arousal ratings of words in the setting of a large, observational, population-based study. Method transfer yielded acceptable data quality. The analyses demonstrated small effects of the selected predictors in the arousal dimension.

Negative content enhances stimulus-specific cerebral activity during free viewing of pictures, faces, and words.

Negative visual stimuli have been found to elicit stronger brain activation than do neutral stimuli. Such emotion effects have been shown for pictures, faces, and words alike, but the literature suggests stimulus-specific differences regarding locus and lateralization of the activity. In the current functional magnetic resonance imaging study, we directly compared brain responses to passively viewed negative and neutral pictures of complex scenes, faces, and words (nouns) in 43 healthy participants (21 males) varying in age and demographic background. Both negative pictures and faces activated the extrastriate visual cortices of both hemispheres more strongly than neutral ones, but effects were larger and extended more dorsally for pictures, whereas negative faces additionally activated the superior temporal sulci. Negative words differentially activated typical higher-level language processing areas such as the left inferior frontal and angular gyrus. There were small emotion effects in the amygdala for faces and words, which were both lateralized to the left hemisphere. Although pictures elicited overall the strongest amygdala activity, amygdala response to negative pictures was not significantly stronger than to neutral ones. Across stimulus types, emotion effects converged in the left anterior insula. No gender effects were apparent, but age had a small, stimulus-specific impact on emotion processing. Our study specifies similarities and differences in effects of negative emotional content on the processing of different types of stimuli, indicating that brain response to negative stimuli is specifically enhanced in areas involved in processing of the respective stimulus type in general and converges across stimuli in the left anterior insula.

Rhinal and hippocampal contributions to spontaneous inter-item binding and verbal memory recall: Evidence from temporal lobe epilepsy.

The medial temporal lobes (MTL) play a prominent role in associative memory processing. Still, it is unclear to what extent specific structures within the MTL sub-serve distinct aspects of associative memory. Here, the role of the MTL in forming spontaneous associations in a "naturalistic" setting is investigated applying a word-list memory test not presenting items in an associative fashion. This allows for the differential investigation of item recall and associative binding. Participants included patients with medial temporal lobe epilepsy (mTLE, n = 79) and healthy controls (n = 58). Memory performance in a verbal list-learning paradigm was analyzed by (1) inter-trial repetitions ("binding", i.e., number of word-pairs consistently recalled over two consecutive trials), and (2) single item recall. In patients, behavioral results were correlated with rhinal cortex and hippocampal volumetric data. Results showed that binding was specifically diminished for patients with mTLE during learning and delayed recall. Moreover, binding predicted behavioral differences in item recall. Notably, hippocampal volumes were correlated with item recall during delayed recall, whereas rhinal cortex volumes were correlated with binding during learning. Our results provide evidence that diminished verbal memory in patients with mTLE at least partly can be attributed to functional reductions in spontaneous inter-trial stimulus binding. Moreover, they demonstrate a process-dependent functional dissociation between rhinal cortex and hippocampus for verbal encoding and recall: While the rhinal cortex is mainly engaged in detecting novel associations, the hippocampus primarily subserves consolidation and recall of associations between stimuli. Our study thus advances current models of the sub-specialization of MTL structures and offers novel evidence that memory formation in the MTL is mediated by associative item-processing, even when stimuli are not presented in an associative fashion per se. Thus, our results provide valuable qualitative insights into mechanisms of memory formation and memory failures in patients with MTL dysfunctions.

Mood Induction Differently Affects Early Neural Correlates of Evaluative Word Processing in L1 and L2.

We investigate how mood inductions impact the neural processing of emotional adjectives in one's first language (L1) and a formally acquired second language (L2). Twenty-three student participants took part in an EEG experiment with two separate sessions. Happy or sad mood inductions were followed by series of individually presented positive, negative, or neutral adjectives in L1 (German) or L2 (English) and evaluative decisions had to be performed. Visual event-related potentials elicited during word processing were analyzed during N1 (125-200 ms), Early Posterior Negativities (EPN, 200-300 ms and 300-400 ms), N400 (350-450 ms), and the Late Positive Potential (LPP, 500-700 ms). Mood induction differentially impacted word processing already on the N1, with stronger left lateralization following happy than sad mood induction in L1, but not in L2. Moreover, regardless of language, early valence modulation was found following happy but not sad mood induction. Over occipital areas, happy mood elicited larger amplitudes of the mood-congruent positive words, whereas over temporal areas mood-incongruent negative words had higher amplitudes. In the EPN-windows, effects of mood and valence largely persisted, albeit with no difference between L1 and L2. N400 amplitude was larger for L2 than for L1. On the LPP, mood-incongruent adjectives elicited larger amplitudes than mood-congruent ones. Results reveal a remarkably early valence-general effect of mood induction on cortical processing, in line with previous reports of N1 as a first marker of contextual integration. Interestingly, this effect differed between L1 and L2. Moreover, mood-congruent effects were found in perceptual processing and mood-incongruent ERP amplification in higher-order evaluative stages.

[ and Riding as Well? Case Report about the Treatment of an Infant with Unresponsive Wakefulness Syndrome]. / und jetzt auch noch reiten? Fallbericht zur Behandlung eines Kleinkindes im Syndrom reaktionsloser Wachheit.

BACKGROUND: There is a growing number of children surviving birth complications with severe, multiple disabilities. Unfortunately, this is not paralleled by equal growth in knowledge about adequate therapeutic approaches. Some publications showed that Hippotherapy could, under certain circumstances, be a very useful complimentary therapy for a range of disabilities. But it remains unclear if riding could even help a quadriplegic individual with multiple brain damage and tracheal ventilation. METHOD: In this case study we examined the effect of horse riding on the mobility of joints and heart rate in a little girl with multiple disabilities. RESULTS: We found a statistically significant increase in joint mobility and a significant decrease in the heart-rate (down to a normal resting frequency). We also had a rather unexpected effect of the hippotherapy. Namely, while on horseback, the girl demonstrated a sufficient spontaneous breathing. No additional oxygen was needed. CONCLUSION: Horse-back riding helped our patient to reduce her symptoms. Therefore, it showed clear positive effects even for a girl with severe and multiple disabilities.

A tree of life? Multivariate logistic outcome-prediction in disorders of consciousness.

Background: Clinical outcome of patients with disorders of consciousness (DOC) is seen as generally very poor. Here, we specify individual outcome chances for patients with DOC on the basis of clinical and event-related-potentials (ERPs) data and identify subgroups, who vary substantially regarding their outcome chances.Methods: We employed data from 102 patients and used standard clinical protocol data (age, etiology, diagnosis, gender), sensory (N100, Mismatch-Negativity) and cognitive (P300, N400) ERPs to predict patients' recovery rates.Results: Two significant prediction models emerged: In both, subgroups of patients with good (51%, tree 1) to very good recovery chances (97%, tree 2) could be identified. The first model was obtained from standard clinical data. The second model included cognitive ERPs and resulted in considerably better patient classification. Moreover, when taking cognitive ERPs into account, the standard protocol data did not add further significant information, neither did sensory ERPs.Conclusion: The presented information about outcome chances of individual patients with DOC will be vital for these patients and critical for clinical professionals who have to direct specialized treatments and council relatives. Legal guardians and families, in turn, need to know what to expect in the future in order to prepare for the challenges ahead.

Attending to Eliza: rapid brain responses reflect competence attribution in virtual social feedback processing.

In the age of virtual communication, the source of a message is often inferred rather than perceived, raising the question of how sender attributions affect content processing. We investigated this issue in an evaluative feedback scenario. Participants were told that an expert psychotherapist, a layperson or a randomly acting computer was going to give them online positive, neutral or negative personality feedback while high-density EEG was recorded. Sender attribution affected processing rapidly, even though the feedback was on average identical. Event-related potentials revealed a linear increase with attributed expertise beginning 150 ms after disclosure and most pronounced for N1, P2 and early posterior negativity components. P3 and late positive potential amplitudes were increased for both human senders and for emotionally significant (positive or negative) feedback. Strikingly, feedback from a putative expert prompted large P3 responses, even for inherently neutral content. Source analysis localized early enhancements due to attributed sender expertise in frontal and somatosensory regions and later responses in the posterior cingulate and extended visual and parietal areas, supporting involvement of mentalizing, embodied processing and socially motivated attention. These findings reveal how attributed sender expertise rapidly alters feedback processing in virtual interaction and have implications for virtual therapy and online communication.

Emotion in Context: How Sender Predictability and Identity Affect Processing of Words as Imminent Personality Feedback.

Recent findings suggest that communicative context affects the timing and magnitude of emotion effects in word processing. In particular, social attributions seem to be one important source of plasticity for the processing of affectively charged language. Here, we investigate the timing and magnitude of ERP responses toward positive, neutral, and negative trait adjectives during the anticipation of putative socio-evaluative feedback from different senders (human and computer) varying in predictability. In the first experiment, during word presentation participants could not anticipate whether a human or a randomly acting computer sender was about to give feedback. Here, a main effect of emotion was observed only on the late positive potential (LPP), showing larger amplitudes for positive compared to neutral adjectives. In the second study the same stimuli and set-up were used, but a block-wise presentation was realized, resulting in fixed and fully predictable sender identity. Feedback was supposedly given by an expert (psychotherapist), a layperson (unknown human), and again by a randomly acting computer. Main effects of emotion started with an increased P1 for negative adjectives, followed by effects at the N1 and early posterior negativity (EPN), showing both largest amplitudes for positive words, as well as for the LPP, where positive and negative words elicited larger amplitudes than neutral words. An interaction revealed that emotional LPP modulations occurred only for a human sender. Finally, regardless of content, anticipating human feedback led to larger P1 and P3 components, being highest for the putative expert. These findings demonstrate the malleability of emotional language processing by social contexts. When clear predictions can be made, our brains rapidly differentiate between emotional and neutral information, as well as between different senders. Attributed human presence affects emotional language processing already during feedback anticipation, in line with a selective gating of attentional resources via anticipatory social significance attributions. By contrast, emotion effects occur much later, when crucial social context information is still missing. These findings demonstrate the context-dependence of emotion effects in word processing and are particularly relevant since virtual communication with unknown senders, whose identity is inferred rather than perceived, has become reality for millions of people.